Organization
PROCARE MEDICAL SUPPLY AND DISTRIBUTION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW ADEDAPO ADESIDA (PRESIDENT)
(310) 748-9904
Entity
Organization
Contact information
Practice address
1910 W REDONDO BEACH BLVD, GARDENA, CA 90247-3624
(310) 515-0507
(310) 515-1668
Mailing address
1910 W REDONDO BEACH BLVD, GARDENA, CA 90247-3624
(310) 515-0507
(310) 515-1668
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332B00000X
CA
Other
Enumeration date
10/12/2006
Last updated
08/22/2020
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